Preliminary Results in Tracheal Replacement Using Stented Aortic Matrices for Primary Extensive Tracheal Cancer

Overview

Journal JTCVS Tech

Date 2023 Oct 19

PMID 37854807

Authors

Ilaria Onorati

Dana M Radu

Ana Maria Santos Portela

Marine Peretti

Patrice Guiraudet

Jeremy Bardet

Olivia Freynet

Morgane Didier

Yurdagul Uzunhan

Kader Chouahnia

Boris Duchemann

Valerian Bourinet

Herve Dutau

Jean-Philippe Berthet

Charles-Hugo Marquette

Francois Tronc

Myriam Locatelli Sanchez

Christophe Tresallet

Clement Fournier

Nicolas Venissac

Makoto Miyara

Eric Vicaut

Emmanuel Martinod

Affiliations

Soon will be listed here.

Abstract

Objective: Recent studies have demonstrated the feasibility and favorable long-term results of tracheobronchial replacement using stented cryopreserved aortic allografts. We propose to investigate the outcomes of this emerging technique in the subgroup of patients with extensive tracheal cancer.

Methods: This study was based on 13 patients with primary extensive tracheal cancer extracted from the prospective registry TRITON-01 (ClinicalTrials.gov Identifier: NCT04263129), which included 40 patients in total. We analyzed early and late outcomes in this subset of patients.

Results: From March 2019 to September 2022, 13 patients were included in the study. There were 9 female and 4 male patients, with a mean age of 53.9 years [36-71 years]. They had tracheal replacement for extended adenoid cystic carcinoma (n = 11), squamous cell carcinoma (n = 1), and mucoepidermoid carcinoma (n = 1). A venovenous extracorporeal membrane oxygenation was used in the 6 last cases. The mean length of resection was 81 mm [50-120 mm]. There was no 30-day postoperative mortality. A complete resection (R0) was achieved in 11 patients. The main late complications consisted of tracheal granulomas related to the stent and requiring repeated bronchoscopies (n = 9), pneumonia (n = 3), airway infection (n = 1), bronchoesophageal fistula (n = 1), mechanical stent obstruction requiring change (n = 2), and mediastinitis treated by antibiotics, drainage, and omentoplasty (n = 1). With a maximal follow-up of 3 years and 7 months, cancer recurrence was observed in 2 patients. All patients were alive at last follow-up except 2 (84.6%).

Conclusions: Airway replacement using stented CAA represents a feasible and promising solution for extensive tracheal cancer.

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